National Provider Identifier [NPI]: |
1811964554 |
Last Name Of The Provider |
KEMMERER |
First Name Of The Provider |
SCOTT |
Middle Initial Of The Provider |
R |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1949 GUNBARREL RD |
Street Address 2 Of The Provider |
SUITE 170 |
City Of The Provider |
CHATTANOOGA |
Zip Code Of The Provider |
374213188 |
State Code Of The Provider |
TN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Diagnostic Radiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
228 |
Number Of Services |
25235 |
Number Of Medicare Beneficiaries |
2473 |
Total Submitted Charge Amount |
1819896.06 |
Total Medicare Allowed Amount |
348319.83 |
Total Medicare Payment Amount |
267042.83 |
Total Medicare Standardized Payment Amount |
292419.9 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
9 |
Number Of Drug Services |
21156 |
Number Of Medicare Beneficiaries With Drug Services |
263 |
Total Drug Submitted ChargeAmount |
70656.06 |
Total Drug Medicare AllowedAmount |
16354.57 |
Total Drug Medicare PaymentAmount |
12716.14 |
Total Drug Medicare Standardized Payment Amount |
12716.14 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
219 |
Number Of Medical Services |
4079 |
Number Of Medicare Beneficiaries With Medical Services |
2469 |
Total Medical Submitted Charge Amount |
1749240 |
Total Medical Medicare Allowed Amount |
331965.26 |
Total Medical Medicare Payment Amount |
254326.69 |
Total Medical Medicare Standardized Payment Amount |
279703.76 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
595 |
Number Of Beneficiaries Age 65 to 74 |
956 |
Number Of Beneficiaries Age 75 to 84 |
664 |
Number Of Beneficiaries Age Greater 84 |
258 |
Number Of Female Beneficiaries |
1595 |
Number Of Male Beneficiaries |
878 |
Number Of Non Hispanic White Beneficiaries |
2272 |
Number Of Black or African American Beneficiaries |
156 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
19 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
1731 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
742 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
14 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
23 |
Percent Of With Chronic Kidney Disease |
27 |
Percent Of With Chronic Obstructive Pulmonary Disease |
28 |
Percent Of With Depression |
27 |
Percent Of With Diabetes |
36 |
Percent Of With Hyperlipidemia |
54 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
38 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
54 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.444 |